Fear of breast cancer is widespread among women, and rightfully so. In the United States, about 1 in 8 women will develop breast cancer in their lifetime. Still, it’s important to note the significant advancements in both screening and treatment in recent years.

Current guidelines recommend that women with an average lifetime risk for developing breast cancer begin to have mammograms at age 40. Thanks to advances in breast imaging technology and in the field of genetics, women now have new tools available to determine if they’re at an increased risk compared to the average population and should consider additional screening or testing in addition to an annual mammogram.

“It’s so important to offer women a comprehensive approach to assess their needs and assist them to determine the appropriate screening and risk management plan,” said Dr. Rebecca Yang, a fellowship-trained surgeon and medical director of the Lahey Comprehensive Breast Health Center.

Lahey Health started offering patients a new risk assessment app that will help determine their personal risk for breast cancer. Anyone getting a mammogram at Lahey sites in Beverly, Gloucester, Danvers, Lexington, Peabody or Burlington, will have access to the app. This Cancer Risk Assessment (CRA) tool can establish a patient’s lifetime risk for developing breast cancer and estimate how likely it is the familial cancer will develop.

Women who take the risk assessment answer a series of questions on a tablet, on areas that include age, medical history, gynecologic history, family history and lifestyle habits. This information is then used to develop a risk score.

Because 95 percent of those who carry genetic markers for breast cancer are unaware of their risk, this tool allows women who have a breast cancer associated mutation start earlier screening with both mammograms and breast MRIs, as well as to have the opportunity to consider risk-reducing surgery.

“The breast cancer screening program is designed to help women make informed decisions about their health and be proactive in their screening choices and risk reduction strategies.” Dr. Yang said.

So far, the screening program has compiled data from over 14,000 surveys and has identified more than 2,000 candidates for genetic screening and over 500 candidates for genetic testing.

For women with greater than a 20 percent lifetime risk, current guidelines from the National Comprehensive Cancer Network (NCCN) and the American Cancer Society say a breast MRI accompanying the mammogram is ideal. The MRI has been shown to increase cancer detection rates in women particularly with an elevated risk of breast cancer.

A patient will be referred to a breast health specialist if the CRA tool indicates a high risk. The specialist will evaluate the case and possibly recommend adding MRI screening.

If women have a family history that is possibly linked to a genetic mutation, they are referred to one of Lahey’s fulltime board certified genetic counselors for genetic counseling to determine if testing is appropriate. Genetic tests are used to identify mutations (inherited changes in genes) that increase a woman’s risk of developing breast and ovarian cancer. Tests involve taking a sample of the patient’s DNA using a blood draw sample or cheek swab. Positive tests do not indicate that a person will absolutely develop cancer, but can help inform future decisions about their screening options and risk reduction strategies.

“The more we learn about breast cancer and how differently it manifests in individuals, the greater the imperative for early screening and testing among high-risk patients,” Dr. Yang said.

“Identifying risk early allows us to work with women to determine what management or treatment options might work best. It also helps our patients become more comfortable talking about risk, allowing them to take a more proactive, data-driven approach to their care.”